| NPI | 1487492161 |
|---|---|
| Doing Business As | MADISON AVENUE PAHRMACY |
| Entity Type | Organization |
| Authorized Contact | JEFFRY WOLFENDEN President 423-746-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2024-07-17 |
| Last Update Date | 2024-07-17 |